More from WebMD

May 1, 2012 -- Memphis residents may have a new reason to sing the blues, if they can catch their breath.

A new report ranks the southern city as the most challenging city in the U.S. to live with asthma, followed closely by New Haven, Conn., and Knoxville, Tenn.

The 2012 list of "Asthma Capitals" takes into account factors like prevalence of asthma, poor air quality, and use of asthma medications in the nation's 100 largest metro areas.

"Many local community issues like air pollution, poverty, or crowded emergency rooms are asthma-related issues that affect one patient at a time, one day at a time, right here in our own cities and towns," says Bill McLin, president and CEO of the Asthma and Allergy Foundation of America (AAFA), which compiled the report.

Overall, the report showed that the prevalence of asthma in the top 100 cities did not change much from 2011 to 2012. Meanwhile, the average air quality improved from a grade of D in 2011 to a C- in 2012.

Asthma Cities: The Best and the Worst

2012 Ranking

City

1

Memphis, Tenn.

2

New Haven, Conn.

3

Knoxville, Tenn.

4

Pittsburgh, Pa.

5

Chattanooga, Tenn.

6

Hartford, Conn.

7

St. Louis, Mo.

8

Oklahoma City, Okla.

9

McAllen, Texas

10

Allentown, Pa.

At the bottom of the list, the top 10 least challenging places to live with asthma are:

2012 Ranking

City

100

San Francisco, Calif.

99

Seattle, Wash.

98

Portland, Ore.

97

Greenville, S.C.

96

Baton Rouge, La.

95

Kansas City, Mo.

94

Austin, Texas

93

Omaha, Neb.

92

Charleston, S.C.

91

Des Moines, Iowa

Asthma: National Problem, Local Risks

Researchers say the report is a reminder that asthma is a national problem, with nearly 25 million people in the U.S. living with the condition. But the risk factors for many asthma problems are local.

Asthma is a chronic disease in which the airways in the lungs narrow and make it difficult to breathe. During an asthma attack, a person may experience chest tightness, coughing, shortness of breath, and wheezing.

Asthma triggers can include several factors, such as air pollution, pollen, and exposure to cigarette smoke.

These were among the more obvious of the 12 key factors that decided the group's rankings.

But the researchers also looked at access to proper medications, as well as the prevalence of asthma and asthma-related deaths in each of the cities studied.

Management of the disease includes reducing exposure to triggers as well as use of controller medications such as inhaled steroids, and quick relief or rescue inhalers such as short-acting bronchodilators. But for some people, additional medication may be needed.

"There is still no cure for asthma," says McLin, "so that's why we need to keep up global attention and keep pushing for advances in asthma care."